A New Guidewire Technique for Difficult Cardiac Catheterization

Purpose: To propose a simple guidewire technique to resolve the problem of difficulty in advancing catheters or guidewires during vascular and cardiac catheterization. Methods: A 0.035-inch J-tip guidewire was reshaped manually at the distal 7- to 8-cm portion, including the flexible part and 2-3 cm of the stiff part, into zig-zag shape. With this modification, the guidewire became much more trackable and could be advanced to the right position. Results: In the past 2 years, this 'zigzag wire technique' was applied in cardiac catheterization with high success rates for cases with difficulty in advancing either catheters or guidewires. This wire technique was applied in peripheral arterial tortuosity or stenosis (18 cases, with success in 17), aortic aneurysm ( successful in all 7 cases), aortic stenosis (11 cases, successful in 8), and dilated right heart chambers (successful in all 6 cases). No complications resulted from the use of this guidewire technique. Conclusion: This simple method of guidewire modification would be very helpful in difficult vascular and cardiac catheterization when difficulty in advancing catheters or wires was encountered. Copyright (C) 2002 S. Karger AG, Basel.